crossing96/oncoscreening huggingface dataset:
Utility of Postoperative Serial Renal Function Monitoring in Patients Undergoing Radical Cystectomy for Urothelial Carcinoma.	PURPOSE: The aim of this study is to examine the rates of clinical actions (CAs) as a result of serial creatinine (SCr) values and to examine postoperative SCr trends to assess the utility of SCr measurements in radical cystectomy (RC) patients. METHODS: We performed a retrospective chart review using our institution's database on all patients who underwent radical cystectomy for urothelial carcinoma (UC) from 2009 to 2019. Preoperative and all postoperative inpatient creatinine values were recorded. Minor CAs included fluid boluses, fluid rate changes, and medication changes. Major CAs included OR take-backs for stent repositioning, nephrostomy tube placement, nephrology consultation, and hemodialysis. RESULTS: A total of 238 RCs were performed with a resultant 2952 SCr measurements. The median number of SCr measurements per patient was 9 (interquartile range, IQR 7) with median length of hospital stay of 10 days (IQR 9 days). There were 92 minor and 12 major CAs as a result of 3% and 0.44% of SCr measurements, respectively. All major CAs were seen in patients experiencing complicated postoperative course. The median postoperative day with the highest creatinine was day 2. Predictors of postoperative CAs included preoperative renal dysfunction and obesity. CONCLUSION: SCr measurements remain a clinically valuable tool in postoperative management. Nonetheless, this present study suggests that prolonged SCr monitoring is of limited clinical utility. As such, discontinuing SCr checks after postoperative day 3 in patients experiencing uncomplicated postoperative course is safe and may lead to both cost savings and decreased patient discomfort.	bladder
[Follow-up in superficial and metastatic bladder cancer].	Concerning follow-up in bladder cancer, it must be distinguished between superficial, muscle-invasive, and metastatic tumors. In superficial bladder cancer, urethrocystoscopy is still standard for follow-up. Frequency depends on the risk classification. Even muscle-invasive carcinomas, which underwent a R0 resection, will metastasize in about 30% of cases. These tumors as well as primarily metastasized cancer cannot be cured. Therefore, in these cases, one should not speak about follow-up but therapeutic control. Nonetheless, even in these cases the S3 guideline recommends regular follow-up examinations because new therapeutic options can clearly improve patient survival. Possible complications of urinary diversions need consideration during follow-up.	bladder
Urachal adenocarcinoma: A case report and review of the literature.	The urachus is a canal between the allantois and the early fetal bladder. Urachal carcinoma is a rare and aggressive type of bladder cancer. This cancer usually presents at an advanced stage. We report a 70-year-old patient with malignant transformation of urachal cyst several years later. The patient was treated with partial cystectomy and adjuvant radiotherapy. A review of the published literature is also presented.	bladder
Marital status independently predicts survival of patients with upper urinary tract urothelial carcinoma: A population-based study.	BACKGROUND: To evaluate impact of marital status on survival of patients with upper urinary tract urothelial carcinoma (UTUC). METHODS: Data of patients diagnosed with UTUC from 2010 to 2015 were identified and retrieved from the Surveillance, Epidemiology, and End Results database. The impact of marital status on overall survival (OS) and cancer-specific survival (CSS) was analyzed using Kaplan-Meier survival curve method and compared with the log-rank test. Multivariate survival analysis of OS and CSS was conducted using the Cox proportional hazards regression model. RESULTS: A total of 4520 eligible patients with UTUC were included in this study. The 5-year OS rates of married patients, never-married patients, and separated, divorced, or widowed (SDW) patients were 47.3%, 43.7%, and 39.2%, respectively (P < 0.001), and the corresponding 5-year CSS rates were 57.7%, 55.2%, and 51.5%, respectively (P = 0.005). In multivariate analyses, marital status was an independent prognostic factor for OS (P < 0.001) and CSS (P = 0.002) of patients with UTUC. Compared to married patients, never married (hazard ratio [HR], 1.187; 95% confidence interval [CI], 1.016-1.386 for OS; HR, 1.102; 95% CI, 0.877-1.385 for CSS) and SDW (HR, 1.205; 95% CI, 1.094-1.327 for OS; HR, 1.309; 95% CI, 1.131-1.514 for CSS) patients showed poor OS and unfavorable CSS. CONCLUSIONS: Marital status was an independent prognostic factor for OS and CSS in patients with UTUC. Married patients with UTUC experienced longer OS and a more favorable CSS than their never married and SDW counterparts.	bladder
Diagnostic accuracy and discriminative power of biparametric versus multiparametric MRI in predicting muscle-invasive bladder cancer.	PURPOSE: Investigate and compare the diagnostic accuracy and discriminative power of biparametric MRI (bp-MRI) and multiparametric MRI (mp-MRI) in predicting muscle-invasive bladder cancer (MIBC) based on Vesical Imaging-Reporting and Data System (VI-RADS) scoring and evaluate potentially influencing factors on both protocols' accuracy. METHOD: This retrospective study included 54 bladder cancer (BC) patients who underwent bladder MRI and histo-pathological assessment. Three readers independently reviewed the MRI studies and assigned a 1-5 score for T2-weighted, diffusion-weighted, and dynamic contrast-enhanced images. Then, bp-MRI and mp-MRI final VI-RADS scores were recorded for each BC. Diagnostic tables, chi-square test, kappa score (k), logistic regression, receiver operating characteristics (ROC) curves, areas under the curves (AUCs), and VI-RADS cut-off values were calculated. A Delong test was performed for ROC curve comparison. A P-value<0.05 was considered significant. RESULTS: In predicting MIBC, bp-MRI and mp-MRI had comparable diagnostic accuracy with insignificant differences for the three readers (P = 0.364,0.718,0.702). Radiologists' experience, and tumors' size and morphology had insignificant effect on bp-MRI accuracy (P = 0.086, 0.392,0.294), respectively. Tumors' size significantly influenced mp-MRI accuracy (P = 0.039). Bp-MRI and mp-MRI had comparable discriminative power with insignificant differences for all readers (P > 0.05). Using VI-RADS > 3 cut-off value improved the discriminative power of bp-MRI. Excellent inter-reader agreement in VI-RADS scoring for bp-MRI (k range, 0.814-0.867) and mp-MRI (k range, 0.787-0.859) was observed. CONCLUSION: Bp-MRI and mp-MRI demonstrated comparable diagnostic accuracy and discriminative power in predicting MIBC. The accuracy of bp-MRI was not influenced by radiologists' experience, or tumors' size and morphology.	bladder
Outcomes of Lymph Node Dissection in Nephroureterectomy in the Treatment of Upper Tract Urothelial Carcinoma: Analysis of the ROBUUST Registry.	PURPOSE: We sought to evaluate outcomes of lymph node dissection (LND) in patients with upper tract urothelial carcinoma. MATERIALS AND METHODS: We performed a multicenter retrospective analysis utilizing the ROBUUST (for RObotic surgery for Upper Tract Urothelial Cancer Study) registry for patients who did not undergo LND (pNx), LND with negative lymph nodes (pN0) and LND with positive nodes (pN+). Primary and secondary outcomes were overall survival (OS) and recurrence-free survival (RFS). Multivariable analyses evaluated predictors of outcomes and pathological node positivity. Kaplan-Meier analyses (KMAs) compared survival outcomes. RESULTS: A total of 877 patients were analyzed (LND performed in 358 [40.8%]/pN+ in 73 [8.3%]). Median nodes obtained were 10.2 for pN+ and 9.8 for pN0. Multivariable analyses noted increasing age (OR 1.1, p <0.001), pN+ (OR 3.1, p <0.001) and pathological stage pTis/3/4 (OR 3.4, p <0.001) as predictors for all-cause mortality. Clinical high-grade tumors (OR 11.74, p=0.015) and increasing tumor size (OR 1.14, p=0.001) were predictive for lymph node positivity. KMAs for pNx, pN0 and pN+ demonstrated 2-year OS of 80%, 86% and 42% (p <0.001) and 2-year RFS of 53%, 61% and 35% (p <0.001), respectively. KMAs comparing pNx, pN0 ≥10 nodes and pN0 <10 nodes showed no significant difference in 2-year OS (82% vs 85% vs 84%, p=0.6) but elicited significantly higher 2-year RFS in the pN0 ≥10 group (60% vs 74% vs 54%, p=0.043). CONCLUSIONS: LND during nephroureterectomy in patients with positive lymph nodes provides prognostic data, but is not associated with improved OS. LND yields ≥10 in patients with clinical node negative disease were associated with improved RFS. In high-grade and large tumors, lymphadenectomy should be considered.	bladder
5-Methylcytosine-Related Long Noncoding RNAs Are Potential Biomarkers to Predict Overall Survival and Regulate Tumor-Immune Environment in Patients with Bladder Cancer.	The role of 5-methylcytosine-related long noncoding RNAs (m5C-lncRNAs) in bladder cancer (BLCA) remains unclear. Here, we aim to study the prognostic value, gene expression characteristics, and correlation between the m5C-lncRNA risk model and the tumor microenvironment, immune infiltration, and tumor mutations in BLCA. After collecting BLCA patient RNA sequence transcriptome data, clinical information and mutation data from the Cancer Genome Atlas (TCGA) database, 17 m5C-related lncRNAs independently correlated with OS were obtained by Lasso and multivariate Cox regression analysis, and a risk model was constructed. Univariate Cox, multivariate Cox regression analysis, and the C-index curve proved that the risk model was a significant independent prognostic indicator for patients with BLCA. ESTIMATE and CIBERSORT indicated that the higher the number of immune cells and stromal cells in TME, the higher the prognostic risk. We found that in the low-risk group, the expression levels of immune cells that predicted a good prognosis were higher, including plasma cells, regulatory T cells, and CD 8 T cells. There is a negative correlation between TMB and risk score. The TMB of the low-risk group is significantly higher than that of the high-risk group. In conclusion, the m5C-related risk model is crucial to predict the prognosis of patients with BLCA.	bladder
Three-Dimensional Ultrasound Images in the Assessment of Bladder Tumor Health Monitoring under Deep Learning Algorithms.	This study was aimed at exploring the application value of three-dimensional (3D) ultrasound based on deep learning and continued nursing health monitoring (CNHM) mode in promoting the recovery of bladder cancer patients after surgery. 60 patients who underwent muscular noninvasive superficial bladder cancer and bladder perfusion treatment were selected as the research objects. The patients were randomly divided into two groups: an experimental group (30 cases) and a control group (30 cases). Patients in the experimental group adopted a CNHM model during the bladder perfusion treatment. The patients in control group adopted ordinary health monitoring mode. All patients underwent 3D ultrasound examination, and all images were processed using the convolutional neural network (CNN) algorithm. All patients were followed up regularly within 12 after the treatment. The imaging data, quality of life, satisfaction, and complications of the two groups of patients were compared in each time period. The ultrasound image processed by the CNN algorithm was clearer than that processed by the original method, showing higher image quality and more prominent lesion features. After 12 months of health monitoring intervention, the overall health status, scores of various functional areas, and score of functional subscales of the experimental group were greatly higher than those of the control group, and the differences were statistically significant (P < 0.05). The incidence of adverse reactions in the experimental group was much lower than that in the control group, and the difference was statistically obvious (P < 0.05). The comparison of the recurrence rate between the two groups of patients in each time period was statistically significant. The satisfaction score of the experimental group was much higher than the score of the control group, showing statistically significant difference (P < 0.05). CNN algorithm showed high application value in 3D ultrasound image processing, and the CNHM model was very beneficial to the postoperative recovery of bladder cancer patients.	bladder
Annular-shaped stenosis in the ureter: Caution should be taken.	OBJECTIVE: To draw the attention of clinicians and avoid the misdiagnosis, we investigate the relationship between annular-shaped stenosis under ureteroscopy and the clinicopathological features and prognosis in patients with primary urothelial carcinoma of the ureter that have been treated by radical nephroureterectomy. METHOD: We reviewed the records of patients with primary urothelial carcinoma of the ureter who had received radical nephroureterectomy in our hospital between January 2014 and June 2020. Based on the luminal morphology of the ureteral lesion, patients were divided into two groups: Group A for annular stenosis and Group B for non-annular stenosis. The logistic regression and Cox proportional-hazards models were used to explore the relationship between annular stenosis and clinicopathological findings. RESULTS: We investigated a total of 147 patients in this study, including 30 patients (20.4%) in Group A and 117 (79.6%) patients in Group B. The proportion of patients with diabetes mellitus was significantly higher in group A than in group B (66.6% vs. 38.5%, P = 0.006), and the percentage of patients undergoing ureteroscopy with biopsy was also significantly higher in group A than in group B (100% vs. 35.9%, P < 0.001). Besides, the logistic regression model revealed that annular-shaped stenosis was correlated to advanced T-stage (P = 0.002) and worse tumour grade (P < 0.001). During a median follow-up of 35 months (range: 6-73), 45 (30.6%) patients died, including 35 (23.8%) who died of ureteral carcinoma. The 5-year overall survival rate in Group A was significantly lower than in Group B (33.7% vs. 56.1%, P = 0.004). Similarly, the 5-year cancer-specific survival rate in Group A was also considerably lower than Group B (36.7% vs. 64.8%, P = 0.009). According to the multivariate Cox regression analysis that included only preoperative parameters, annular-shaped stenosis was an independent risk factor for both overall survival and cancer-specific survival (P = 0.006, P = 0.012, respectively). CONCLUSION: Annular-shaped stenosis indicates high carcinoma invasiveness and poor prognosis for patients with primary transitional cell carcinoma of the ureter. This condition can be easily misidentified, so clinicians should pay more attention when making diagnoses. Additionally, we discovered that diabetes mellitus may contribute to the development of annular stenosis.	bladder
"Distal ureter and bladder cuff excision using the ""Keyhole Technique"" during Robotic Radical Nephroureterectomy."	"INTRODUCTION: Upper tract urothelial carcinoma (UTUC) accounts for 5-10% of all urothelial tumors (1). Radical nephroureterectomy (RNU) remains the standard treatment for high, and low-grade UTUC (2). Although the open approach has been considered the gold standard, robotic techniques have shown comparable oncological outcomes with potential advantages in terms of peri-operative morbidity (3). MATERIALS AND METHODS: We present a novel ""Keyhole"" technique for management of distal ureter and bladder cuff during robotic RNU. This technique allows the surgeon to directly visualize the ureteric orifices, delineate resection borders, and maintain oncologic principles of en-bloc excision without necessitating secondary cystotomy incision or concomitant endoscopic procedure. Descriptive demographic characteristics, surgical, pathological, and oncological outcomes were analyzed. Complications were reported using the Clavien-Dindo classification system. RESULTS: Between 2015 and 2020, ten patients underwent robotic RNU with bladder cuff excision using the Keyhole technique (single-dock, single-position). Median age was 75 years. Eight patients underwent surgery for right-sided tumors. Median operative time, estimated blood loss, and length of hospital stay were 287 min, 100 mL, and 3 days, respectively. No intraoperative complications occurred, and one grade II complication occurred during the 90-day postoperative period. All patients had high-grade UTUC, being 90% pure urothelial. Bladder recurrences occurred in 30% of patients with an overall median follow-up of 11.2 months. CONCLUSIONS: Keyhole technique for the management of distal ureter and bladder cuff during RNU represents a feasible approach with minimal 90-day complications and low bladder recurrence rate at centers of experience."	bladder
Contacts to general practice in the 12 months preceding a diagnosis of an abdominal cancer: a national register-based cohort study.	OBJECTIVE: To compare the number of contacts to general practice across 11 types of abdominal cancer in the 12 months preceding a diagnosis. DESIGN: Nationwide register study. SETTING: Danish general practice. SUBJECTS: Forty-seven thousand eight hundred and ninety-eight patients diagnosed with oesophageal, gastric, colon, rectal, liver, gall bladder/biliary tract, pancreatic, endometrial, ovarian, kidney or bladder cancer in 2014-2018. MAIN OUTCOME MEASURES: Monthly contact rates and incidence rate ratios (IRRs) of daytime face-to-face, email and telephone consultations in general practice across different abdominal cancers. The analyses were conducted for each sex and adjusted for age, comorbidity, marital status and education. RESULTS: Compared to women with colon cancer, women with rectal cancer had the lowest number of contacts to general practice (IRR 12 months pre-diagnostic (IRR(-12))=0.86 (95% CI: 0.80-0.92); IRR 1 month pre-diagnostic (IRR(-1))=0.85 (95% CI: 0.81-0.89)), whereas women with liver (IRR(-12)=1.23 (95% CI: 1.09-1.38); IRR(-1)=1.11 (95% CI: 1.02-1.20)), pancreatic (IRR(-12)=1.08 (95% CI: 1.01-1.16); IRR(1)=1.52 (95% CI: 1.45-1.58)) and kidney cancer (IRR(-12)=1.14 (95% CI: 1.05-1.23); IRR(-1)=1.18 (95% CI: 1.12-1.24)) had the highest number of contacts. Men showed similar patterns. From seven months pre-diagnostic, an increase in contacts to general practice was seen in bladder cancer patients, particularly women, compared to colon cancer. CONCLUSIONS: Using pre-diagnostic contact rates unveiled that liver, pancreatic, kidney and bladder cancers had a higher and more prolonged use of general practice. This may suggest missed opportunities of diagnosing cancer. Thus, pre-diagnostic contact rates may indicate symptoms and signs for cancer that need further research to ensure early cancer diagnosis.Key pointsThe majority of cancer patients attend their general practitioner (GP) before diagnosis; however, little is known about the use of general practice across different abdominal cancers.This study suggests that a potential exists to detect some abdominal cancers at an earlier point in time.The contact patterns in general practice seem to be shaped by the degree of diagnostic difficulty.GPs may need additional diagnostic opportunities to identify abdominal cancer in symptomatic patients.	bladder
Online adaptive radiotherapy of urinary bladder cancer with full re-optimization to the anatomy of the day: Initial experience and dosimetric benefits.	BACKGROUND AND PURPOSE: Online adaptive radiotherapy (oART) potentially reduces the dose to organs at risk (OARs) as the planning target volume (PTV) margins are reduced compared to a non-adaptive approach (non-ART). This study evaluates the feasibility and dosimetric impact of cone-beam computed tomography (CBCT)-guided oART of urinary bladder cancer for the first patients treated, using patient-specific margins. MATERIALS AND METHODS: Sixteen consecutive patients with muscle-invasive bladder cancer received two or more (median = 23) fractions as oART, and remaining fractions as non-ART. The non-ART fractions were delivered with standard population-based margins, while reduced patient-specific margins based on intra-fractional variations extracted from 2-4 fractions were applied to the primary PTV (PTV-T) during the oART fractions. Target volume and coverage, and dose to OARs were compared between non-ART and oART plans, and the oART procedure time was recorded. RESULTS: In total, 297/512 fractions were delivered as oART with full re-optimization to the anatomy of the day. The median (interquartile range, IQR) oART procedure time, measured from the end of CBCT generation to completion of plan review, and quality assurance was 13.9 (11.9;16.6) min. The median (IQR) volume reduction in PTV-T volume was 33.9 (24.2;45.0)%, comparing oART and non-ART plans, resulting in median (IQR) reductions in bowel bag V(45)(Gy) of 18.8 (12.7;27.9)% and rectum V(50)(Gy) of 70.7 (35.9;94.8)%. By re-optimizing the plan to the daily anatomy, full target coverage was achieved at all oART fractions. CONCLUSIONS: oART resulted in large reductions in treatment volumes and doses to OARs, compared to non-ART, while ensuring target coverage. This indicates potential reductions in gastrointestinal toxicity.	bladder
Histological variants of non-muscle invasive bladder cancer: Survival outcomes of radical cystectomy vs. bladder preservation therapy.	BACKGROUND: To compare the overall survival (OS) outcomes of non-muscle invasive bladder cancer (NMIBC) patients with variant histology who underwent radical cystectomy (RC) vs. bladder preservation therapy (BPT). METHODS: We investigated the National Cancer Database for NMIBC patients with variant histological features. Patients diagnosed with micropapillary, sarcomatoid, neuroendocrine, squamous, and glandular variants were identified. Inverse probability weighting (IPW)-adjusted Kaplan Meier survival curves and Cox proportional hazard models were utilized to compare OS in the setting of RC versus BPT. RESULTS: A total of 8,920 (2.7%) NMIBC patients presented with variant histology, of whom 2,450 (27.5%) underwent RC, while 6,470 (72.5%) had BPT. When compared with BPT, patients who underwent RC had significantly higher 5-year OS rates for sarcomatoid (31.9% vs. 23.3%, P < 0.001) neuroendocrine (31% vs. 21.7%, P < 0.001), glandular (44% vs. 41%, P = 0.04) and squamous variants (39.7% vs 19.9%, P < 0.001). This OS benefit was not observed with micropapillary variant (43.9% vs. 53.2% P = 0.14). IPW-adjusted log-rank analysis identified RC as an independent predictor of OS for patients with sarcomatoid (hazards ratio [HR] 0.78, confidence interval [CI] 0.71-0.85, P < 0.001), squamous (HR 0.56, CI 0.53-0.59, P < 0.001), and neuroendocrine variants (HR 0.83, CI 0.76-0.91, P < 0.001), but not for micropapillary variant (HR 1.45, CI 1.24-1.7, P < 0.001). CONCLUSIONS: Among NMIBC patients presenting with variant histologies, RC was associated with better OS for sarcomatoid, squamous, glandular, and neuroendocrine variants when compared to BPT. This OS survival benefit was not observed in patients with micropapillary variant suggesting a potential role for bladder preservation in such population.	bladder